Individual
MRS. LISA KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 GUSTAVE L LEVY PL, NY, NY 10029
(631) 379-6886
Mailing address
211 ELM CT, SCOTCH PLAINS, NJ 07076
(631) 379-6886
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012029-1
NY
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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